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Federal funding for ambulance services at risk

Ambulance services throughout New York state are at risk of losing millions of dollars in federal reimbursements as a plan is set to expire without congressional action.

Ambulances get paid by Medicaid and Medicare less than it costs to respond to emergencies from patients on those insurance plans, but one-year programs by Congress have boosted those rates. The Senate Finance Committee has approved a longer-term extension on reimbursements. Sen. Charles Schumer, D-N.Y., says he wants a five-year guarantee.

"Locking in the ambulance payments for five years would be really important," Schumer said. "It ends the year to year budget concerns, and gives them certainty so they can invest in cutting edge medical devices and ambulances."

Schumer is pushing for more than $40 million in Medicare reimbursements for ambulances statewide, with about $20 million coming to upstate New York. He says at its current pace, Medicare payments to private, non-profit and volunteer ambulances services barely keep up with the costs to keep them well-equipped and prepared.

The debate around ambulance reimbursements is part of discussions on how much to reimburse doctors who treat Medicaid and Medicare patients.

But Schumer is also looking at the state's hospitals, by pushing legislation through the Senate that will provide funding for Low Volume Hospital Programs and Medicare-dependent hospitals throughout the state.

Low Volume Hospitals are hospitals that don't see many patients, but still serve a vital role in the community. They must be more than 15 miles from a comparable hospital and see fewer than 1,600 Medicare discharges a year. Medicare-dependent hospitals are those in rural areas that have fewer than 100 beds and have at least 60 percent of their visits covered by Medicare.

The legislation would permanently deliver $14 million each year to 22 upstate hospitals, including two that are included as both low volume and Medicare-dependent.

Schumer says if the law is passed by the Senate, it will be a major help for hospitals that rely on those payments to continue providing high-quality services.

According to the National Rural Health Association, if a hospital closes it can cost its local economy up to 20 percent of its revenue.